Steerable laser probe

ABSTRACT

A steerable laser probe may include a handle, and inner bore of the handle, an actuation lever of the handle, a housing tube, and an optic fiber disposed within the inner bore of the handle and the housing tube. The housing tube may have a first housing tube portion having a first stiffness and a second housing tube portion having a second stiffness. The second stiffness may be greater than the first stiffness.

CROSS-REFERENCE TO RELATED APPLICATIONS

This Application is a continuation of prior application Ser. No.13/602,037, filed Aug. 31, 2012.

FIELD OF THE INVENTION

The present disclosure relates to a surgical instrument, and, moreparticularly, to a steerable laser probe.

BACKGROUND OF THE INVENTION

A wide variety of ophthalmic procedures require a laser energy source.For example, ophthalmic surgeons may use laser photocoagulation to treatproliferative retinopathy. Proliferative retinopathy is a conditioncharacterized by the development of abnormal blood vessels in the retinathat grow into the vitreous humor. Ophthalmic surgeons may treat thiscondition by energizing a laser to cauterize portions of the retina toprevent the abnormal blood vessels from growing and hemorrhaging.

In order to increase the chances of a successful laser photocoagulationprocedure, it is important that a surgeon is able aim the laser at aplurality of targets within the eye, e.g., by guiding or moving thelaser from a first target to a second target within the eye. It is alsoimportant that the surgeon is able to easily control a movement of thelaser. For example, the surgeon must be able to easily direct a laserbeam by steering the beam to a first position aimed at a first target,guide the laser beam from the first position to a second position aimedat a second target, and hold the laser beam in the second position.Accordingly, there is a need for a surgical laser probe that can beeasily guided to a plurality of targets within the eye.

BRIEF SUMMARY OF THE INVENTION

The present disclosure provides a steerable laser probe. In one or moreembodiments, a steerable laser probe may comprise a handle, and innerbore of the handle, an actuation lever of the handle, a housing tube,and an optic fiber disposed within the inner bore of the handle and thehousing tube. Illustratively, the housing tube may comprise a firsthousing tube portion having a first stiffness and a second housing tubeportion having a second stiffness. In one or more embodiments, thesecond stiffness may be greater than the first stiffness.

Illustratively, an actuation of the actuation lever may be configured togradually curve the housing tube. In one or more embodiments, a gradualcurving of the housing tube may be configured to gradually curve theoptic fiber. Illustratively, an actuation of the actuation lever may beconfigured to gradually straighten the housing tube. In one or moreembodiments, a gradual straightening of the housing tube may beconfigured to gradually straighten the optic fiber.

BRIEF DESCRIPTION OF THE DRAWINGS

The above and further advantages of the present invention may be betterunderstood by referring to the following description in conjunction withthe accompanying drawings in which like reference numerals indicateidentical or functionally similar elements:

FIGS. 1A and 1B are schematic diagrams illustrating a handle;

FIGS. 2A, 2B, and 2C are schematic diagrams illustrating a housing tube;

FIG. 3 is a schematic diagram illustrating a steerable laser probeassembly;

FIGS. 4A and 4B are schematic diagrams illustrating an assembledsteerable laser probe;

FIGS. 5A, 5B, 5C, 5D, and 5E are schematic diagrams illustrating agradual curving of an optic fiber;

FIGS. 6A, 6B, 6C, 6D, and 6E are schematic diagrams illustrating agradual straightening of an optic fiber.

DETAILED DESCRIPTION OF AN ILLUSTRATIVE EMBODIMENT

FIGS. 1A and 1B are schematic diagrams illustrating a handle 100. FIG.1A illustrates a side view of handle 100. In one or more embodiments,handle 100 may comprise a handle distal end 101, a handle proximal end102, a pivot pin housing 110, and an actuation lever channel 120. FIG.1B illustrates a cross-sectional view of handle 100. In one or moreembodiments, handle 100 may comprise a fixation pin housing 130, aninner bore 140, an actuation lever guide 150, a piston guide 160, and ahousing tube guide 170. Handle 100 may be manufactured from any suitablematerial, e.g., polymers, metals, metal alloys, etc., or from anycombination of suitable materials.

FIGS. 2A, 2B, and 2C are schematic diagrams illustrating a housing tube200. In one or more embodiments, housing tube 200 may comprise a housingtube distal end 201 and a housing tube proximal end 202. Housing tube200 may be manufactured from any suitable material, e.g., polymers,metals, metal alloys, etc., or from any combination of suitablematerials. Illustratively, housing tube 200 may be manufactured withdimensions suitable for performing microsurgical procedures, e.g.,ophthalmic surgical procedures.

FIG. 2A illustrates a housing tube 200 oriented to illustrate a firsthousing tube portion 220. Illustratively, first housing tube portion 220may have a first stiffness. FIG. 2B illustrates a housing tube 200oriented to illustrate a second housing tube portion 230.Illustratively, second housing tube portion 230 may have a secondstiffness. In one or more embodiments, the second stiffness may begreater than the first stiffness. Illustratively, first housing tubeportion 220 may comprise a first material having a first stiffness. Inone or more embodiments, second housing tube portion 230 may comprise asecond material having a second stiffness. Illustratively, the secondstiffness may be greater than the first stiffness.

In one or more embodiments, housing tube 200 may comprise a non-uniforminner diameter or a non-uniform outer diameter, e.g., to vary astiffness of one or more portions of housing tube 200. Illustratively, afirst housing tube portion 220 may comprise a first inner diameter ofhousing tube 200 and a second housing tube portion 230 may comprise asecond inner diameter of housing tube 200. In one or more embodiments,the first inner diameter of housing tube 200 may be larger than thesecond inner diameter of housing tube 200. Illustratively, a firsthousing tube portion 220 may comprise a first outer diameter of housingtube 200 and a second housing tube portion 230 may comprise a secondouter diameter of housing tube 200. In one or more embodiments, thefirst outer diameter of housing tube 200 may be smaller than the secondouter diameter of housing tube 200.

In one or more embodiments, first housing tube portion 220 may compriseone or more apertures configured to produce a first stiffness of firsthousing tube portion 220. Illustratively, second housing tube portion230 may comprise a solid portion of housing tube 200 having a secondstiffness. In one or more embodiments, the second stiffness may begreater than the first stiffness. Illustratively, first housing tubeportion 220 may comprise one or more apertures configured to produce afirst stiffness of first housing tube portion 220. In one or moreembodiments, second housing tube portion 230 may comprise one or moreapertures configured to produce a second stiffness of second housingtube portion 230. Illustratively, the second stiffness may be greaterthan the first stiffness.

In one or more embodiments, first housing tube portion 220 may comprisea plurality of slits configured to separate one or more solid portionsof housing tube 200. Illustratively, a plurality of slits may be cut,e.g., laser cut, into first housing tube portion 220. In one or moreembodiments, first housing tube portion 220 may comprise a plurality ofslits configured to minimize a force of friction between housing tube200 and a cannula, e.g., as housing tube 200 is inserted into thecannula or as housing tube 200 is extracted from the cannula. Forexample, each slit of the plurality of slits may comprise one or morearches configured to minimize a force of friction between housing tube200 and a cannula.

FIG. 2C illustrates an angled view of housing tube 200. Illustratively,an optic fiber 250 may be disposed within housing tube 200. In one ormore embodiments, optic fiber 250 may be disposed within housing tube200 wherein an optic fiber distal end 251 is adjacent to housing tubedistal end 201. Illustratively, optic fiber 250 may be disposed withinhousing tube 200 wherein optic fiber 250 may be adjacent to a portion offirst housing tube portion 220. In one or more embodiments, a portion ofoptic fiber 250 may be fixed to an inner portion of housing tube 200,e.g., by an adhesive or by any suitable fixation means.

Illustratively, a cable 240 may be disposed within housing tube 200. Inone or more embodiments, cable 240 may be disposed within housing tube200 wherein a cable distal end 241 may be adjacent to housing tubedistal end 201. Illustratively, cable 240 may be disposed within housingtube 200 wherein cable 240 may be adjacent to a portion of first housingtube portion 220. In one or more embodiments, a portion of cable 240 maybe fixed to an inner portion of housing tube 200, e.g., by an adhesiveor by any suitable fixation means.

FIG. 3 is a schematic diagram illustrating a steerable laser probeassembly 300. In one or more embodiments, steerable laser probe assembly300 may comprise a handle 100, a pivot pin 310, an actuation lever 320having an actuation lever distal end 321 and an actuation lever proximalend 322, a fixation pin 330, a piston 340 having a piston distal end 341and a piston proximal end 342, a housing tube 200 having a housing tubedistal end 201 and a housing tube proximal end 202, a cable 240 having acable distal end 241 and a cable proximal loop 242, an optic fiber 250having an optic fiber distal end 251 and an optic fiber proximal end252, and a light source interface 350. Illustratively, light sourceinterface 350 may be configured to interface with optic fiber 250, e.g.,at optic fiber proximal end 252. In one or more embodiments, lightsource interface 350 may comprise a standard light source connecter,e.g., an SMA connector.

FIGS. 4A and 4B are schematic diagrams illustrating an assembledsteerable laser probe 400. FIG. 4A illustrates a side view of anassembled steerable laser probe 400. FIG. 4B illustrates across-sectional view of an assembled steerable laser probe 400.Illustratively, piston 340 may be disposed within piston guide 160. Inone or more embodiments, piston 340 may be configured to actuate withinpiston guide 160. Illustratively, a portion of housing tube 200 may befixed to piston 340, e.g., housing tube proximal end 202 may be fixed topiston distal end 341. In one or more embodiments, a portion of housingtube 200 may be fixed to piston 340, e.g., by an adhesive or anysuitable fixation means. Illustratively, a portion of housing tube 200may be disposed within piston 340, e.g., housing tube proximal end 202may be disposed within piston 340. In one or more embodiments, a portionof housing tube 200 may be fixed within piston 340, e.g., by an adhesiveor by any suitable means. Illustratively, a portion of housing tube 200may be disposed within housing tube guide 170. In one or moreembodiments, housing tube 200 may be configured to actuate withinhousing tube guide 170.

Illustratively, a portion of actuation lever 320 may be disposed withinactuation lever guide 150, e.g., actuation lever proximal end 322 may bedisposed within actuation lever guide 150. In one or more embodiments,actuation lever 320 may comprise a pivot pin chamber 325 configured toenclose a portion of pivot pin 310. Illustratively, pivot pin 310 may bedisposed within both pivot pin housing 110 and pivot pin chamber 325. Inone or more embodiments, pivot pin 310 may be fixed within pivot pinhousing 110. Illustratively, pivot pin 310 may be fixed within pivot pinhousing 110, e.g., by an adhesive or by any suitable fixation means. Inone or more embodiments, pivot pin 310 may be configured to fix aportion of actuation lever 320 to handle 100, e.g., at pivot pin chamber325. Illustratively, when pivot pin 310 is disposed within pivot pinchamber 325, pivot pin 310 may be configured to limit an actuation ofactuation lever 320, e.g., to allow rotational actuation of actuationlever 320 about pivot pin 310. In one or more embodiments, actuationlever 320 may be configured to rotate about pivot pin 310, e.g., inresponse to an application of a force to a portion of actuation lever320. Illustratively, pivot pin chamber 325 may be coated by a lubricant,e.g., Teflon, configured to facilitate a rotation of actuation lever 320about pivot pin 310.

In one or more embodiments, optic fiber 250 may be disposed within innerbore 140, actuation lever guide 150, piston guide 160, piston 340,housing tube guide 170, and housing tube 200. Illustratively, opticfiber 250 may be disposed within housing tube 200 wherein optic fiberdistal end 251 may be adjacent to housing tube distal end 201. In one ormore embodiments, a portion of optic fiber 250 may be fixed to an innerportion of housing tube 200. Illustratively, a portion of optic fiber250 may be fixed within housing tube 200, e.g., by an adhesive or anysuitable fixation means.

In one or more embodiments, cable 240 may be disposed within fixationpin housing 130, inner bore 140, actuation lever guide 150, piston guide160, piston 340, housing tube guide 170, and housing tube 200.Illustratively, cable 240 may be disposed within housing tube 200wherein cable distal end 241 may be adjacent to housing tube distal end201. In one or more embodiments, cable 240 may be disposed withinhousing tube 200 wherein a portion of cable 240 may be adjacent to firsthousing tube portion 220. Illustratively, a portion of cable 240 may befixed to an inner portion of housing tube 200. In one or moreembodiments, a portion of cable 240 may be fixed within housing tube200, e.g., by an adhesive or any suitable fixation means.Illustratively, fixation pin 330 may be configured to fix cable 240 in aposition relative to handle 100. In one or more embodiments, fixationpin 330 may be disposed within fixation pin housing 130 and cableproximal loop 242. Illustratively, fixation pin 330 may comprise a setscrew configured to firmly fix cable 240 in a position relative tohandle 100. In one or more embodiments, a portion of cable 240 may befixed to fixation pin 330, e.g., by an adhesive or any suitable fixationmeans.

Illustratively, an actuation of actuation lever 320 about pivot pin 310in a counter-clockwise direction may be configured to cause actuationlever 320 to apply a force to piston proximal end 342. In one or moreembodiments, an application of a force to piston proximal end 342 may beconfigured to actuate piston 340 within piston guide 160.Illustratively, an application of a force to piston proximal end 342 maybe configured to extend piston 340 relative to handle proximal end 102.In one or more embodiments, an extension of piston 340 relative tohandle proximal end 102 may be configured to extend housing tube 200relative to handle proximal end 102. Illustratively, an extension ofhousing tube 200 relative to handle proximal end 102 may be configuredto extend housing tube 200 relative to cable 240. In one or moreembodiments, an extension of housing tube 200 relative to cable 240 maybe configured to cause cable 240 to apply a force, e.g., a compressiveforce, to a portion of housing tube 200. For example, if a portion ofcable 240 is fixed in a position relative to handle 100 and a portion ofcable 240 is also fixed within housing tube 200, then an extension ofhousing tube 200 relative to handle 100 and cable 240 may apply a forceto a portion of housing tube 200. Illustratively, an application of aforce to a portion of housing tube 200 may be configured to compress aportion of housing tube 200, e.g., first housing tube portion 220,causing housing tube 200 to gradually curve. In one or more embodiments,a gradual curving of housing tube 200 may be configured to graduallycurve optic fiber 250.

Illustratively, an actuation of actuation lever 320 about pivot pin 310in a clockwise direction may be configured to cause actuation lever 320to reduce a force applied to piston proximal end 342. In one or moreembodiments, a reduction of a force applied to piston proximal end 342may be configured to actuate piston 340 within piston guide 160.Illustratively, a reduction of a force applied to piston proximal end342 may be configured to retract piston 340 relative to handle proximalend 102. In one or more embodiments, a retraction of piston 340 relativeto handle proximal end 102 may be configured to retract housing tube 200relative to handle proximal end 102. Illustratively, a retraction ofhousing tube 200 relative to handle proximal end 102 may be configuredto retract housing tube 200 relative to cable 240. In one or moreembodiments, a retraction of housing tube 200 relative to cable 240 maybe configured to cause cable 240 to reduce a force, e.g., a compressiveforce, applied to a portion of housing tube 200. Illustratively, areduction of a force applied to a portion of housing tube 200 may beconfigured to decompress a portion of housing tube 200, e.g., firsthousing tube portion 220, causing housing tube 200 to graduallystraighten. In one or more embodiments, a gradual straightening ofhousing tube 200 may be configured to gradually straighten optic fiber250.

FIGS. 5A, 5B, 5C, 5D, and 5E are schematic diagrams illustrating agradual curving of an optic fiber 250. FIG. 5A illustrates a straightoptic fiber 500. In one or more embodiments, optic fiber 250 maycomprise a straight optic fiber 500, e.g., when piston 340 is fullyretracted relative to handle proximal end 102. Illustratively, opticfiber 250 may comprise a straight optic fiber 500, e.g., when housingtube 200 is fully refracted relative to cable 240. In one or moreembodiments, optic fiber 250 may comprise a straight optic fiber 500,e.g., when first housing tube portion 220 is fully decompressed.Illustratively, a line tangent to optic fiber distal end 251 may beparallel to a line tangent to housing tube proximal end 202, e.g., whenoptic fiber 250 comprises a straight optic fiber 500.

FIG. 5B illustrates an optic fiber in a first curved position 510. Inone or more embodiments, a rotation of actuation lever 320 about pivotpin 310 in a counter-clockwise direction may be configured to graduallycurve optic fiber 250 from a straight optic fiber 500 to an optic fiberin a first curved position 510. Illustratively, a rotation of actuationlever 320 about pivot pin 310 in a counter-clockwise direction may beconfigured to gradually extend piston 340 relative to handle proximalend 102. In one or more embodiments, a gradual extension of piston 340relative to handle proximal end 102 may be configured to graduallyextend housing tube 200 relative to cable 240. Illustratively, a gradualextension of housing tube 200 relative to cable 240 may be configured tocause cable 240 to apply a force, e.g., a compressive force, to aportion of housing tube 200. In one or more embodiments, an applicationof a force to a portion of housing tube 200 may be configured tocompress a portion of housing tube 200, e.g., first housing tube portion220. Illustratively, a compression of a portion of housing tube 200,e.g., first housing tube portion 220, may be configured to graduallycurve housing tube 200. In one or more embodiments, a gradual curving ofhousing tube 200 may be configured to gradually curve optic fiber 250,e.g., from a straight optic fiber 500 to an optic fiber in a firstcurved position 510. Illustratively, a line tangent to optic fiberdistal end 251 may intersect a line tangent to housing tube proximal end202 at a first angle, e.g., when optic fiber 250 comprises an opticfiber in a first curved position 510. In one or more embodiments, thefirst angle may comprise any angle greater than zero degrees. Forexample, the first angle may comprise a 45 degree angle.

FIG. 5C illustrates an optic fiber in a second curved position 520. Inone or more embodiments, a rotation of actuation lever 320 about pivotpin 310 in a counter-clockwise direction may be configured to graduallycurve optic fiber 250 from an optic fiber in a first curved position 510to an optic fiber in a second curved position 520. Illustratively, arotation of actuation lever 320 about pivot pin 310 in acounter-clockwise direction may be configured to gradually extend piston340 relative to handle proximal end 102. In one or more embodiments, agradual extension of piston 340 relative to handle proximal end 102 maybe configured to gradually extend housing tube 200 relative to cable240. Illustratively, a gradual extension of housing tube 200 relative tocable 240 may be configured to cause cable 240 to apply a force, e.g., acompressive force, to a portion of housing tube 200. In one or moreembodiments, an application of a force to a portion of housing tube 200may be configured to compress a portion of housing tube 200, e.g., firsthousing tube portion 220. Illustratively, a compression of a portion ofhousing tube 200, e.g., first housing tube portion 220, may beconfigured to gradually curve housing tube 200. In one or moreembodiments, a gradual curving of housing tube 200 may be configured togradually curve optic fiber 250, e.g., from an optic fiber in a firstcurved position 510 to an optic fiber in a second curved position 520.Illustratively, a line tangent to optic fiber distal end 251 mayintersect a line tangent to housing tube proximal end 202 at a secondangle, e.g., when optic fiber 250 comprises an optic fiber in a secondcurved position 520. In one or more embodiments, the second angle maycomprise any angle greater than the first angle. For example, the secondangle may comprise a 90 degree angle.

FIG. 5D illustrates an optic fiber in a third curved position 530. Inone or more embodiments, a rotation of actuation lever 320 about pivotpin 310 in a counter-clockwise direction may be configured to graduallycurve optic fiber 250 from an optic fiber in a second curved position520 to an optic fiber in a third curved position 530. Illustratively, arotation of actuation lever 320 about pivot pin 310 in acounter-clockwise direction may be configured to gradually extend piston340 relative to handle proximal end 102. In one or more embodiments, agradual extension of piston 340 relative to handle proximal end 102 maybe configured to gradually extend housing tube 200 relative to cable240. Illustratively, a gradual extension of housing tube 200 relative tocable 240 may be configured to cause cable 240 to apply a force, e.g., acompressive force, to a portion of housing tube 200. In one or moreembodiments, an application of a force to a portion of housing tube 200may be configured to compress a portion of housing tube 200, e.g., firsthousing tube portion 220. Illustratively, a compression of a portion ofhousing tube 200, e.g., first housing tube portion 220, may beconfigured to gradually curve housing tube 200. In one or moreembodiments, a gradual curving of housing tube 200 may be configured togradually curve optic fiber 250, e.g., from an optic fiber in a secondcurved position 520 to an optic fiber in a third curved position 530.Illustratively, a line tangent to optic fiber distal end 251 mayintersect a line tangent to housing tube proximal end 202 at a thirdangle, e.g., when optic fiber 250 comprises an optic fiber in a thirdcurved position 530. In one or more embodiments, the third angle maycomprise any angle greater than the second angle. For example, the thirdangle may comprise a 135 degree angle.

FIG. 5E illustrates an optic fiber in a fourth curved position 540. Inone or more embodiments, a rotation of actuation lever 320 about pivotpin 310 in a counter-clockwise direction may be configured to graduallycurve optic fiber 250 from an optic fiber in a third curved position 530to an optic fiber in a fourth curved position 540. Illustratively, arotation of actuation lever 320 about pivot pin 310 in acounter-clockwise direction may be configured to gradually extend piston340 relative to handle proximal end 102. In one or more embodiments, agradual extension of piston 340 relative to handle proximal end 102 maybe configured to gradually extend housing tube 200 relative to cable240. Illustratively, a gradual extension of housing tube 200 relative tocable 240 may be configured to cause cable 240 to apply a force, e.g., acompressive force, to a portion of housing tube 200. In one or moreembodiments, an application of a force to a portion of housing tube 200may be configured to compress a portion of housing tube 200, e.g., firsthousing tube portion 220. Illustratively, a compression of a portion ofhousing tube 200, e.g., first housing tube portion 220, may beconfigured to gradually curve housing tube 200. In one or moreembodiments, a gradual curving of housing tube 200 may be configured togradually curve optic fiber 250, e.g., from an optic fiber in a thirdcurved position 530 to an optic fiber in a fourth curved position 540.Illustratively, a line tangent to optic fiber distal end 251 may beparallel to a line tangent to housing tube proximal end 202, e.g., whenoptic fiber 250 comprises an optic fiber in a fourth curved position540.

In one or more embodiments, one or more properties of a steerable laserprobe may be adjusted to attain one or more desired steerable laserprobe features. For example, a length that housing tube distal end 201extends from piston distal end 341 may be adjusted to vary a degree ofrotation of actuation lever 320 configured to curve housing tube 200 toa particular curved position. Illustratively, a length of cable 240 maybe adjusted to vary a degree of rotation of actuation lever 320configured to curve housing tube 200 to a particular curved position. Inone or more embodiments, a stiffness of first housing tube portion 220or a stiffness of second housing tube portion 230 may be adjusted tovary a degree of rotation of actuation lever 320 configured to curvehousing tube 200 to a particular curved position. Illustratively, amaterial comprising first housing tube portion 220 or a materialcomprising second housing tube portion 230 may be adjusted to vary adegree of rotation of actuation lever 320 configured to curve housingtube 200 to a particular curved position.

In one or more embodiments, a number of apertures in housing tube 200may be adjusted to vary a degree of rotation of actuation lever 320configured to curve housing tube 200 to a particular curved position.Illustratively, a location of one or more apertures in housing tube 200may be adjusted to vary a degree of rotation of actuation lever 320configured to curve housing tube 200 to a particular curved position. Inone or more embodiments, a geometry of one or more apertures in housingtube 200 may be adjusted to vary a degree of rotation of actuation lever320 configured to curve housing tube 200 to a particular curvedposition. Illustratively, a geometry of one or more apertures in housingtube 200 may be uniform, e.g., each aperture of the one or moreapertures may have a same geometry. In one or more embodiments, ageometry of one or more apertures in housing tube 200 may benon-uniform, e.g., a first aperture in housing tube 200 may have a firstgeometry and a second aperture in housing tube 200 may have a secondgeometry.

Illustratively, a position of pivot pin 310 may be adjusted to vary adegree of rotation of actuation lever 320 configured to curve housingtube 200 to a particular curved position. In one or more embodiments, ageometry of actuation lever 320 may be adjusted to vary a degree ofrotation of actuation lever 320 configured to curve housing tube 200 toa particular curved position. Illustratively, one or more locationswithin housing tube 200 wherein cable 240 may be fixed to an innerportion of housing tube 200 may be adjusted to vary a degree of rotationof actuation lever 320 configured to curve housing tube 200 to aparticular curved position. In one or more embodiments, at least aportion of optic fiber 250 may be enclosed in an optic fiber sleeveconfigured to, e.g., protect optic fiber 250, vary a stiffness of opticfiber 250, vary an optical property of optic fiber 250, etc.

Illustratively, an optic fiber sleeve may be configured to compress aportion of housing tube 200. For example, an optic fiber sleeve mayenclose a portion of optic fiber 250 and the optic fiber sleeve may befixed in a position relative to handle 100 and also fixed to a portionof housing tube 200. In one or more embodiments, a rotation of actuationlever 320 about pivot pin 310 in a counter-clockwise direction may beconfigured to extend housing tube 200 relative to an optic fiber sleeve.Illustratively, an extension of housing tube 200 relative to an opticfiber sleeve may be configured to cause the optic fiber sleeve to applya force, e.g., a compressive force, to a portion of housing tube 200. Inone or more embodiments, an application of a force to a portion ofhousing tube 200, e.g., first housing tube portion 220, may beconfigured to compress a portion of housing tube 200 causing housingtube 200 to gradually curve.

Illustratively, a pressure mechanism may be disposed within piston guide160. In one or more embodiments, a pressure mechanism may be configuredto provide a force. Illustratively, a pressure mechanism may comprise aspring or a coil configured to provide a force. In one or moreembodiments, a pressure mechanism may be configured to provide a forceto piston distal end 341. Illustratively, a pressure mechanism mayprovide a facilitating force configured to rotate actuation lever 320 ina clockwise direction about pivot pin 310. In one or more embodiments, apressure mechanism may provide a resistive force configured to resist arotation of actuation lever 320 in a counter-clockwise direction aboutpivot pin 310. Illustratively, a pressure mechanism may provide a forcefacilitating force configured to retract housing tube 200 relative tocable 240. In one or more embodiments, a pressure mechanism may providea resistive force configured to resist an extension of housing tube 200relative to cable 240.

Illustratively, a stiffness of first housing tube portion 220 or astiffness of second housing tube portion 230 may be adjusted to vary abend radius of housing tube 200. In one or more embodiments, a stiffnessof first housing tube portion 220 or a stiffness of second housing tubeportion 230 may be adjusted to vary a radius of curvature of housingtube 200, e.g., when housing tube 200 is in a particular curvedposition. Illustratively, a number of apertures in housing tube 200 maybe adjusted to vary a bend radius of housing tube 200. In one or moreembodiments, a number of apertures in housing tube 200 may be adjustedto vary a radius of curvature of housing tube 200, e.g., when housingtube 200 is in a particular curved position. Illustratively, a locationor a geometry of one or more apertures in housing tube 200 may beadjusted to vary a bend radius of housing tube 200. In one or moreembodiments, a location or a geometry of one or more apertures inhousing tube 200 may be adjusted to vary a radius of curvature ofhousing tube 200, e.g., when housing tube 200 is in a particular curvedposition.

FIGS. 6A, 6B, 6C, 6D, and 6E are schematic diagrams illustrating agradual straightening of an optic fiber 250. FIG. 6A illustrates a fullycurved optic fiber 600. In one or more embodiments, optic fiber 250 maycomprise a fully curved optic fiber 600, e.g., when piston 340 is fullyextended relative to handle proximal end 102. Illustratively, opticfiber 250 may comprise a fully curved optic fiber 600, e.g., whenhousing tube 200 is fully extended relative to cable 240. In one or moreembodiments, optic fiber 250 may comprise a fully curved optic fiber600, e.g., when first housing tube portion 220 is fully compressed.Illustratively, a line tangent to optic fiber distal end 251 may beparallel to a line tangent to housing tube proximal end 202, e.g., whenoptic fiber 250 comprises a fully curved optic fiber 600.

FIG. 6B illustrates an optic fiber in a first partially straightenedposition 610. In one or more embodiments, a rotation of actuation lever320 about pivot pin 310 in a clockwise direction may be configured togradually straighten optic fiber 250 from a fully curved optic fiber 600to an optic fiber in a first partially straightened position 610.Illustratively, a rotation of actuation lever 320 about pivot pin 310 ina clockwise direction may be configured to gradually retract piston 340relative to handle proximal end 102. In one or more embodiments, agradual retraction of piston 340 relative to handle proximal end 102 maybe configured to gradually retract housing tube 200 relative to cable240. Illustratively, a retraction of housing tube 200 relative to cable240 may be configured to reduce a force, e.g., a compressive force,applied to a portion of housing tube 200. In one or more embodiments, areduction of a force applied to a portion of housing tube 200, e.g.,first housing tube portion 220, may be configured to graduallydecompress a portion of housing tube 200. Illustratively, adecompression of a portion of housing tube 200, e.g., first housing tubeportion 220, may be configured to gradually straighten housing tube 200.In one or more embodiments, a gradual straightening of housing tube 200may be configured to gradually straighten optic fiber 250, e.g., from afully curved optic fiber 600 to an optic fiber in a first partiallystraightened position 610. Illustratively, a line tangent to optic fiberdistal end 251 may intersect a line tangent to housing tube proximal end202 at a first partially straightened angle, e.g., when optic fiber 250comprises an optic fiber in a first partially straightened position 610.In one or more embodiments, the first partially straightened angle maycomprise any angle less than 180 degrees. For example, the firstpartially straightened angle may comprise a 135 degree angle.

FIG. 6C illustrates an optic fiber in a second partially straightenedposition 620. In one or more embodiments, a rotation of actuation lever320 about pivot pin 310 in a clockwise direction may be configured togradually straighten optic fiber 250 from an optic fiber in a firstpartially straightened position 610 to an optic fiber in a secondpartially straightened position 620. Illustratively, a rotation ofactuation lever 320 about pivot pin 310 in a clockwise direction may beconfigured to gradually retract piston 340 relative to handle proximalend 102. In one or more embodiments, a gradual retraction of piston 340relative to handle proximal end 102 may be configured to graduallyretract housing tube 200 relative to cable 240. Illustratively, aretraction of housing tube 200 relative to cable 240 may be configuredto reduce a force, e.g., a compressive force, applied to a portion ofhousing tube 200. In one or more embodiments, a reduction of a forceapplied to a portion of housing tube 200, e.g., first housing tubeportion 220, may be configured to gradually decompress a portion ofhousing tube 200. Illustratively, a decompression of a portion ofhousing tube 200, e.g., first housing tube portion 220, may beconfigured to gradually straighten housing tube 200. In one or moreembodiments, a gradual straightening of housing tube 200 may beconfigured to gradually straighten optic fiber 250, e.g., from an opticfiber in a first partially straightened position 610 to an optic fiberin a second partially straightened position 620. Illustratively, a linetangent to optic fiber distal end 251 may intersect a line tangent tohousing tube proximal end 202 at a second partially straightened angle,e.g., when optic fiber 250 comprises an optic fiber in a secondpartially straightened position 620. In one or more embodiments, thesecond partially straightened angle may comprise any angle less than thefirst partially straightened angle. For example, the second partiallystraightened angle may comprise a 90 degree angle.

FIG. 6D illustrates an optic fiber in a third partially straightenedposition 630. In one or more embodiments, a rotation of actuation lever320 about pivot pin 310 in a clockwise direction may be configured togradually straighten optic fiber 250 from an optic fiber in a secondpartially straightened position 620 to an optic fiber in a thirdpartially straightened position 630. Illustratively, a rotation ofactuation lever 320 about pivot pin 310 in a clockwise direction may beconfigured to gradually retract piston 340 relative to handle proximalend 102. In one or more embodiments, a gradual retraction of piston 340relative to handle proximal end 102 may be configured to graduallyretract housing tube 200 relative to cable 240. Illustratively, aretraction of housing tube 200 relative to cable 240 may be configuredto reduce a force, e.g., a compressive force, applied to a portion ofhousing tube 200. In one or more embodiments, a reduction of a forceapplied to a portion of housing tube 200, e.g., first housing tubeportion 220, may be configured to gradually decompress a portion ofhousing tube 200. Illustratively, a decompression of a portion ofhousing tube 200, e.g., first housing tube portion 220, may beconfigured to gradually straighten housing tube 200. In one or moreembodiments, a gradual straightening of housing tube 200 may beconfigured to gradually straighten optic fiber 250, e.g., from an opticfiber in a second partially straightened position 620 to an optic fiberin a third partially straightened position 630. Illustratively, a linetangent to optic fiber distal end 251 may intersect a line tangent tohousing tube proximal end 202 at a third partially straightened angle,e.g., when optic fiber 250 comprises an optic fiber in a third partiallystraightened position 630. In one or more embodiments, the thirdpartially straightened angle may comprise any angle less than the secondpartially straightened angle. For example, the third partiallystraightened angle may comprise a 45 degree angle.

FIG. 6E illustrates an optic fiber in a fully straightened position 640.In one or more embodiments, a rotation of actuation lever 320 aboutpivot pin 310 in a clockwise direction may be configured to graduallystraighten optic fiber 250 from an optic fiber in a third partiallystraightened position 630 to an optic fiber in a fully straightenedposition 640. Illustratively, a rotation of actuation lever 320 aboutpivot pin 310 in a clockwise direction may be configured to graduallyretract piston 340 relative to handle proximal end 102. In one or moreembodiments, a gradual retraction of piston 340 relative to handleproximal end 102 may be configured to gradually retract housing tube 200relative to cable 240. Illustratively, a retraction of housing tube 200relative to cable 240 may be configured to reduce a force, e.g., acompressive force, applied to a portion of housing tube 200. In one ormore embodiments, a reduction of a force applied to a portion of housingtube 200, e.g., first housing tube portion 220, may be configured togradually decompress a portion of housing tube 200. Illustratively, adecompression of a portion of housing tube 200, e.g., first housing tubeportion 220, may be configured to gradually straighten housing tube 200.In one or more embodiments, a gradual straightening of housing tube 200may be configured to gradually straighten optic fiber 250, e.g., from anoptic fiber in a third partially straightened position 630 to an opticfiber in a fully straightened position 640. Illustratively, a linetangent to optic fiber distal end 251 may be parallel to a line tangentto housing tube proximal end 202, e.g., when optic fiber 250 comprisesan optic fiber in a fully straightened position 640.

Illustratively, a surgeon may aim optic fiber distal end 251 at any of aplurality of targets within an eye, e.g., to perform a photocoagulationprocedure. In one or more embodiments, a surgeon may aim optic fiberdistal end 251 at any target within a particular transverse plane of theinner eye by, e.g., rotating handle 100 to orient housing tube 200 in anorientation configured to cause a curvature of housing tube 200 withinthe particular transverse plane of the inner eye and varying a degree ofrotation of actuation lever 320 about pivot pin 310. Illustratively, asurgeon may aim optic fiber distal end 251 at any target within aparticular sagittal plane of the inner eye by, e.g., rotating handle 100to orient housing tube 200 in an orientation configured to cause acurvature of housing tube 200 within the particular sagittal plane ofthe inner eye and varying a degree of rotation of actuation lever 320about pivot pin 310. In one or more embodiments, a surgeon may aim opticfiber distal end 251 at any target within a particular frontal plane ofthe inner eye by, e.g., varying a degree of rotation of actuation lever320 about pivot pin 310 to orient a line tangent to optic fiber distalend 251 wherein the line tangent to optic fiber distal end 251 is withinthe particular frontal plane of the inner eye and rotating handle 100.Illustratively, a surgeon may aim optic fiber distal end 251 at anytarget located outside of the particular transverse plane, theparticular sagittal plane, and the particular frontal plane of the innereye, e.g., by varying a rotational orientation of handle 100 and varyinga degree of rotation of actuation lever 320 about pivot pin 310. In oneor more embodiments, a surgeon may aim optic fiber distal end 251 at anytarget of a plurality of targets within an eye, e.g., without increasinga length of a portion of a steerable laser probe within the eye.Illustratively, a surgeon may aim optic fiber distal end 251 at anytarget of a plurality of targets within an eye, e.g., without decreasinga length of a portion of a steerable laser probe within the eye.

The foregoing description has been directed to particular embodiments ofthis invention. It will be apparent; however, that other variations andmodifications may be made to the described embodiments, with theattainment of some or all of their advantages. Specifically, it shouldbe noted that the principles of the present invention may be implementedin any probe system. Furthermore, while this description has beenwritten in terms of a steerable laser probe, the teachings of thepresent invention are equally suitable to systems where thefunctionality of actuation may be employed. Therefore, it is the objectof the appended claims to cover all such variations and modifications ascome within the true spirit and scope of the invention.

What is claimed is:
 1. An instrument comprising: a handle having ahandle distal end and a handle proximal end; an inner bore of the handlehaving a piston guide; a piston having a piston distal end and a pistonproximal end, the piston disposed within the piston guide of the innerbore of the handle wherein the piston distal end is disposed between thehandle distal end and the handle proximal end and the piston proximalend is disposed between the handle distal end and the handle proximalend; a housing tube having a housing tube distal end and a housing tubeproximal end, the housing tube disposed within the piston and a housingtube guide of the handle wherein the housing tube proximal end is fixedwithin an inner bore of the piston and the housing tube distal endextends from the handle distal end; an optic fiber having an optic fiberdistal end and an optic fiber proximal end, the optic fiber disposedwithin the inner bore of the handle and the housing tube wherein theoptic fiber distal end is adjacent to the housing tube distal end; anactuation lever having a pivot pin chamber, the actuation lever fixed tothe handle by a pivot pin disposed within the pivot pin chamber, theactuation lever configured to actuate about the pivot pin and actuatethe piston relative to the handle proximal end wherein the actuationlever is configured to actuate about the pivot pin in a first directionand in a second direction and wherein the piston is disposed between thehandle distal end and the actuation lever; and a cable having a cabledistal end and a cable proximal end, the cable disposed within thehousing tube and within the handle wherein a first portion of the cableis fixed to the housing tube and a second portion of the cable is fixedin a position relative to the handle.
 2. The instrument of claim 1wherein an actuation of the actuation lever about the pivot pin in thefirst direction is configured to curve the optic fiber.
 3. Theinstrument of claim 2 wherein the actuation of the actuation lever aboutthe pivot pin in the first direction is configured to curve the opticfiber within an eye without increasing a length of the instrument withinthe eye.
 4. The instrument of claim 2 wherein the actuation of theactuation lever about the pivot pin in the first direction is configuredto curve the optic fiber within an eye without decreasing a length ofthe instrument within the eye.
 5. The instrument of claim 1 wherein anactuation of the actuation lever about the pivot pin in the seconddirection is configured to straighten the optic fiber.
 6. The instrumentof claim 5 wherein the actuation of the actuation lever about the pivotpin in the second direction is configured to straighten the optic fiberwithin an eye without increasing a length of the instrument within theeye.
 7. The instrument of claim 5 wherein the actuation of the actuationlever about the pivot pin in the second direction is configured tostraighten the optic fiber within an eye without decreasing a length ofthe instrument within the eye.
 8. The instrument of claim 1 wherein anactuation of the actuation lever about the pivot pin in the firstdirection is configured to extend the piston relative to the handleproximal end.
 9. The instrument of claim 1 wherein an actuation of theactuation lever about the pivot pin in the second direction isconfigured to retract the piston relative to the handle proximal end.10. The instrument of claim 1 wherein an actuation of the actuationlever about the pivot pin in the first direction is configured to extendthe housing tube relative to the handle proximal end.
 11. The instrumentof claim 10 wherein the actuation of the actuation lever about the pivotpin in the first direction is configured to extend the housing tuberelative to the cable.
 12. The instrument of claim 1 wherein anactuation of the actuation lever about the pivot pin in the seconddirection is configured to retract the housing tube relative to thehandle proximal end.
 13. The instrument of claim 12 wherein theactuation of the actuation lever about the pivot pin in the seconddirection is configured to retract the housing tube relative to thecable.
 14. An instrument comprising: a handle having a handle distal endand a handle proximal end; an inner bore of the handle having a pistonguide; a piston having a piston distal end and a piston proximal end,the piston disposed within the piston guide of the inner bore of thehandle wherein the piston distal end is disposed between the handledistal end and the handle proximal end and the piston proximal end isdisposed between the handle distal end and the handle proximal end; ahousing tube having a housing tube distal end and a housing tubeproximal end, the housing tube disposed within the piston and a housingtube guide of the handle wherein the housing tube proximal end is fixedwithin an inner bore of the piston and the housing tube distal endextends from the handle distal end; an optic fiber having an optic fiberdistal end and an optic fiber proximal end, the optic fiber disposedwithin the inner bore of the handle and the housing tube wherein theoptic fiber distal end is adjacent to the housing tube distal end; anactuation lever having a pivot pin chamber, the actuation lever fixed tothe handle by a pivot pin disposed within the pivot pin chamber, theactuation lever configured to actuate about the pivot pin and actuatethe piston relative to the handle proximal end wherein the actuationlever is configured to actuate about the pivot pin in a first directionand in a second direction and wherein the piston is disposed between thehandle distal end and the actuation lever; and a cable having a cabledistal end and a cable proximal end, the cable disposed within thehousing tube and within the handle wherein a first portion of the cableis fixed to the housing tube and a second portion of the cable is fixedin a position relative to the handle and wherein an actuation of theactuation lever about the pivot pin in the first direction is configuredto extend the housing tube relative to the cable.
 15. The instrument ofclaim 14 wherein the actuation of the actuation lever about the pivotpin in the first direction is configured to curve the optic fiber. 16.The instrument of claim 14 wherein the actuation of the actuation leverabout the pivot pin in the first direction is configured to curve theoptic fiber within an eye without increasing a length of the instrumentwithin the eye.
 17. The instrument of claim 14 wherein the actuation ofthe actuation lever about the pivot pin in the first direction isconfigured to curve the optic fiber within an eye without decreasing alength of the instrument within the eye.
 18. An instrument comprising: ahandle having a handle distal end and a handle proximal end; an innerbore of the handle having a piston guide; a piston having a pistondistal end and a piston proximal end, the piston disposed within thepiston guide of the inner bore of the handle wherein the piston distalend is disposed between the handle distal end and the handle proximalend and the piston proximal end is disposed between the handle distalend and the handle proximal end; a housing tube having a housing tubedistal end and a housing tube proximal end, the housing tube disposedwithin the piston and a housing tube guide of the handle wherein thehousing tube proximal end is fixed within an inner bore of the pistonand the housing tube distal end extends from the handle distal end; anoptic fiber having an optic fiber distal end and an optic fiber proximalend, the optic fiber disposed within the inner bore of the handle andthe housing tube wherein the optic fiber distal end is adjacent to thehousing tube distal end; an actuation lever having a pivot pin chamber,the actuation lever fixed to the handle by a pivot pin disposed withinthe pivot pin chamber, the actuation lever configured to actuate aboutthe pivot pin and actuate the piston relative to the handle proximal endwherein the actuation lever is configured to actuate about the pivot pinin a first direction and in a second direction and wherein the piston isdisposed between the handle distal end and the actuation lever; and acable having a cable distal end and a cable proximal end, the cabledisposed within the housing tube and within the handle wherein a firstportion of the cable is fixed to the housing tube and a second portionof the cable is fixed in a position relative to the handle and whereinan actuation of the actuation lever about the pivot pin in the seconddirection is configured to retract the housing tube relative to thecable.
 19. The instrument of claim 18 wherein the actuation of theactuation lever about the pivot pin in the second direction isconfigured to straighten the optic fiber.
 20. The instrument of claim 19wherein the actuation of the actuation lever about the pivot pin in thesecond direction is configured to straighten the housing tube.